Toposar is used to treat cancer of the lung or testicles. It is usually given with other cancer medicines in a combination chemotherapy.

Toposar may also be used for purposes not listed in this medication guide.

Toposar can increase your risk of bleeding or infection. Call your doctor if you have unusual bruising or bleeding, or new signs of infection (fever, sore throat, trouble breathing).

Toposar is given as an infusion into a vein. A healthcare provider will give you this injection.

Toposar is usually given as part of a 4-day or 5-day treatment cycle every 3 or 4 weeks. Follow your doctor's dosing instructions very carefully.

Toposar can be harmful if it gets on your skin. If skin contact occurs, wash the area with soap and water.

Toposar can increase your risk of bleeding or infection. You will need frequent medical tests. Your cancer treatments may be delayed based on the results.

You should not be treated with Toposar if you are allergic to it.

Tell your doctor if you have ever had kidney disease.

Using Toposar may increase your risk of developing other types of cancer, such as leukemia. Talk with your doctor about your specific risk.

Toposar can harm an unborn baby if the mother or the father is using Toposar.

• If you are a woman, do not use Toposar if you are pregnant. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.

• If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 4 months after your last dose.

• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using Toposar.

This medicine may affect fertility (ability to have children) in both men and women. However, it is important to use birth control to prevent pregnancy because Toposar can harm an unborn baby.

You should not breastfeed while you are using Toposar.

Call your doctor for instructions if you miss an appointment for your Toposar.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Do not receive a "live" vaccine while using Toposar. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Get emergency medical help if you have signs of an allergic reaction (fever, chills, sweating, hives, fast heartbeats, feeling light-headed, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Toposar may cause serious side effects. Call your doctor at once if you have:

• low white blood cell counts--fever, mouth sores, skin sores, sore throat, cough, trouble breathing;

• easy bruising, unusual bleeding, purple or red spots under your skin;

• severe ongoing nausea or vomiting;

• sudden chest pain, wheezing, dry cough, feeling short of breath;

• upper stomach pain, loss of appetite;

• vision problems; or

• a seizure (convulsions).

Common side effects of Toposar may include:

• low white blood cell counts.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• aspirin;

• warfarin (Coumadin, Jantoven); or

• seizure mediation.

This list is not complete. Other drugs may affect Toposar, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.